by Bruce Cherney (part1)
Peter Thompson* had been married for just two years when he became “so sick and so bewildered,” by what he felt at the time was a “mysterious” ailment.
After visiting with his wife Jean’s aunt and uncle in East Kildonan, the young couple returned to their home, where “I had this funny feeling,” said Thompson, recalling the events of August 1953.
“My legs were heavy and I had no energy. I was so unco-ordinated. I couldn’t focus on anything. I had a headache and severe pain in my back.
“It was such a strange feeling,” he added.
Then just 23 years old, the last thing Thompson remembered while in the midst of his delirium was telling his wife, “I don’t feel so good.”
Thompson, now 80, soon found himself in King George Hospital’s isolation ward as one of hundreds of cases during the great polio epidemic of 1953, a time when fear, bordering on panic, overcame people who believed attending public activities made them more likely to contract the dreaded disease.
The suddenness that the disease struck — similar to Thompson, people could be well one moment and extremely ill the next — added to the apprehension, as did the prospect of polio sentencing its victims to a life of paralysis. The sight of children in iron lungs and severely hobbled by the crippling effects of polio was a heart-wrenching experience for parents, relatives, friends and health-care workers.
The epidemic was a time of such widespread anxiety that today it is indelibly imprinted in the memories of many Manitobans.
“I remember waking up with all these irons lungs” in the ward, Thompson said, “and thinking to myself, ‘I hope I don’t have to be in one.’”
While in the polio ward, Thompson could hear the hum of engines controlling iron lung machines, which have since become the most recognizable symbol of the epidemic and its tragic consequences.
“It was a terrible sight,” said Thompson. “I felt so demoralized, but I was determined not to go into an iron lung.”
What helped him to avoid the fate of so many others, according to Thompson, was his physical condition, the result of a lifelong passion for hockey and other sports. “I had always been physically active,” commented Thompson.
Two weeks later, Thompson recovered enough from his great scare to enable the doctor to pronounce the worst of the disease passed, although it would take another three months to make a full recovery.
“The doctor said I was very fortunate,” added Thompson.
“I had no idea how I got it, and the doctor didn’t know how I got it. It was a great mystery.”
By 1953, a great deal of information from past epidemics had been accumulated on the viral infection Poliomyelitis, although there were wide gaps in the knowledge about the disease. At the time, no one had arrived at a potential cure nor had a vaccine against polio been developed.
At the height of a 1928 polio epidemic in Manitoba, Winnipeg physicians on a committee of the medical society issued a statement on the symptoms, causes and spread of the disease, citing the most recent research available. At the time, it was evident some progress in identifying the cause of polio was being made. The doctors were on the right track when they expressed the belief the virus was spread by contact, although they don’t mention the type of contact required to transmit the disease. “But it is very difficult to prove this,” they added.
“Others believe that the infection may be spread in other ways, but here, even more decidedly, there is no shadow of proof. Ignorance regarding the method of spread makes it difficult to take rational steps in the matter of prevention.”
Over the years leading to the 1953 epidemic, medical professionals speculated the virus was transmitted by flies, in sewage or water, or in the air.
Dr. John L. Paul and Dr. James D. Trask of the Yale University of medicine, during the epidemic sweeping North America in 1941, told the Associated Press, “as poliomyelitis is a disease of summer and in its most severe form a disease of rural areas, the virus in an open sewer or privy must come in contact with many living things.”
The doctors set fly traps in rural areas and found flies carrying the virus of infantile paralysis, the most virulent form of polio, “which when extracted and injected into animals, caused quick crippling and frequent deaths.”
Actually, flies were never a major contributor to the spread of the polio virus.
What is now known is that the polio virus is transmitted from person to person by coming in contact with the stool of an infected person, such as when eating food or drinking liquids contaminated with the virus, touching surfaces or objects (soiled diapers are one source) contaminated with the virus and then placing the contaminated hand in the mouth, or sharing food or utensils with someone infected with the virus. Only rarely is the virus transmitted by coming into contact with respiratory droplets or saliva.
Scientists and other professionals knew since the early 1900s that the virus was found in sewage, and even correctly speculated that it was the result of the presence of contamination by human feces, although they lacked the tools to definitively prove the case.
The prevalence of poliomyelitis cases in June, July, August and September resulted in summer becoming known in newspapers as the “polio season.” When the first cases were reported, health-care workers began to dread the heat of summer, anticipating the outset of colder weather in the fall when epidemics invariably ended.
Yet, severe outbreaks in the depths of winter in northern Canadian communities populated by Inuit showed the disease didn’t respect any particular seasonal pattern. The Inuit and other aboriginal Canadians were particularly susceptible to the virus due to a lack of previous exposure to the “white man’s” disease that would have produced anti-bodies to give them a measure of protection.
Dr. Joseph Moody related in his book Arctic Doctor (1955) how a man named Tutu contracted the disease in Churchill after trading with soldiers and then took the disease to Chesterfield Inlet where it quickly spread. According to notes from the Oblates and Grey Nuns who ran the St. Theresa Hospital at Chesterfield Inlet, five people died between November 16 and 18, 1948. Three Inuit died on February 21 and two weeks later another 11 deaths were recorded. Of the 300 people in the area, Dr. Moody said half became sick, 14 were paralyzed and five per cent died.
Many Chesterfield Inlet Inuit afflicted by polio were sent south to Winnipeg for treatment, including six Inuit who died in an RCAF Canso aircraft crash, 140 kilometres east of Norway House, Manitoba, on their way to the city.
The polio virus enters the mouth, then multiples in the throat and gastrointestinal tract, moves into the bloodstream and is carried to the central nervous system where it replicates and destroys motor neuron cells, which control the muscles for swallowing, circulation, respiration, and the trunk, arms and legs.
The “bulbar” polio cases, in which breathing is severely impaired, require the use of the iron lung. In October 1953 at King George Hospital in Winnipeg, 92 patients were dependent on the machines.
By the summer of 1953 when the Manitoba polio epidemic was at its height, Dr. Charles Read of the Children’s Hospital in Winnipeg was correctly telling the public to thoroughly wash their hands before meals, as “he declared it had been established that polio virus is present in the stools of infected persons and carriers of the disease” (Free Press, September 1, 1953).
There are three distinct strains of the polio virus — it took so long to develop a successful vaccine because it had to be effective against the three strains — which can cause paralysis or short-term symptoms. In many cases, people infected with the virus develop few or no symptoms.
Prior to the 1953 epidemic, there had been several earlier outbreaks recorded in Manitoba: 75 cases in 1918, 434 in 1928, 523 in 1936, 1,011 in 1941, 600 in 1947 and 841 in 1952 (a compilation of numbers from various sources).
“Infantile paralysis occurs in Winnipeg every year,” said Dr. A.J. Douglas, the city’s medical officer (Free Press, August 17, 1936), “and we have been successful in preventing anything like a serious outbreak. The later the outbreak, the better chance we have of nipping an incipient epidemic in the bud. Hot weather is the time for paralysis and the disease disappears when it gets colder.”
The first recorded death from polio was a six-year-old girl reported in September 1916 by Winnipeg General Hospital superintendent Dr. G.W. Sinclair. The girl died during a relatively minor local polio outbreak as only five reported cases were taken to the isolation ward at King George Hospital by early September.
During the 1916 polio outbreak, the United States reported 27,000 cases of paralytic polio with 6,000 deaths.
Outbreaks of paralytic polio were first reported in North America in the 1890s, but it wasn’t until 1910 that the intensity of such outbreaks became more widespread in the United States and Canada.
Ironically, the incidence of paralytic polio increased as sanitation and public health standards improved. Parents became more fastidious in keeping their children clean and isolated from “dirt.” Less exposure to germs meant children didn’t develop the anti-bodies needed to fight diseases. Children’s initial exposure to the polio virus invariably came at a later age when first attending school. Lacking earlier exposure to the virus, school-age children increasingly fell victim to the disease as did adults who did not acquire adequate anti-bodies in their youth to fight the disease.
Another ironic twist is that polio was essentially a disease of the society’s more privileged, predominantly affecting children from better-off families who had more resources to keep their children “germ-free.”
Dr. Morley R. Elliott, the Manitoba deputy health minister, told a Citizens Polio Prevention Committee during a November 1953 meeting at the St. Regis Hotel, health-care officials believed polio didn’t strike “poor” areas as badly as the suburbs, “because we think it is there all the time.”
The doctor said “poor” countries rarely suffered polio epidemics as, “we suspect that these children are affected early in life and develop a mild case which gives them an immunity.”
A 1936 article in the Manitoba Medical Association Review declared: “there is no disease over which the public is more apprehensive in which both the laity and the medical profession feel so helpless than Epidemic Poliomyelitis.”
It was an apprehension most commonly demonstrated by drastic measures taken to keep children from potential contact with those infected by the disease.
“Although medical men contend there is no cause for undue alarm,” reported the August 31, 1928, Manitoba Free Press, “provincial and municipal health authorities yesterday took decided steps with the view of checkmating the epidemic of infantile paralysis that has been prevalent in Winnipeg and districts for the past two months” by calling for schools to remain closed until September 17.
“This action was was taken solely because of the increase of infantile paralysis cases this month.”
Actually, the Free Press said the schools didn’t open in 1928 until October 1, when “for the first time since mid-July not one case of infantile paralysis was reported to civic health authorities” in Winnipeg.
In 1936, paralytic poliomyelitis struck hardest in the Boissevain area. The problem at the time was the province was in the midst of the Great Depression and many parents in rural areas did not seek medical attention for their afflicted children due to a desperate financial position. To address this problem, local governments began to issue bylaws allowing municipalities to pay for examinations by doctors if “any member of a household” was suspected of “developing infantile paralysis.” In addition, local governments assumed “the cost of any further medical attention required.”
The August 18, 1936, Free Press carried a front-page article in which Dr. Bird, the health officer at Boissevain said, “The epidemic of acute poliomyelitis, or infantile paralysis, unfortunately continues unabated, notwithstanding all efforts to prevent its spread.”
Dr. Bird said in a statement to the press that the epidemic’s spread was due to infected people not seeking treatment.
“On Saturday we had one more case, on Sunday three, and early Monday morning one more,” he added. “All cases treated early are recovering without paralysis or other complications.”
When Dr. Bird issued his statement, the epidemic in the Boissevain area had claimed its third victim.
The Free Press reported on October 2, 1936, that “drastic action” was being “taken to block” the epidemic’s advance.
Municipal officials in Rapid City “clapped an embargo on all proposed visits to infected areas,” and ordered incoming visitors to remain in quarantine in their host’s house for two weeks. Officials in Whitehead imposed their own quarantine and social gatherings were banned in Solsgirth.
Polio cases were reported in Argyle municipality, Rosedale, Roblin, Roland, Souris and Springfield, as well as in East Kildonan, Selkirk, St. Boniface, St. Vital and Winnipeg.
In the wake of the 1936 epidemic, the provincial government also began to take on greater financial responsibility for those left hospitalized by polio.
Dr. A.A. Murray, a Winnipeg orthopedic surgeon, undertook a survey of the 1936 epidemic. His finding was that out of 539 cases in Manitoba, 404 of those infected completely recovered, 33 died, residual paralysis of more than one muscle affected 33, and there were 48 instances of residual paralysis of more than one extremity (Winnipeg Evening Tribune, August 9, 1941).
In a report in the October issue of the Manitoba Medical Association Review, Dr. M.R. Elliott wrote that one feature of the Boissevain outbreak was that until 1936 there had not been a case of infantile paralysis in the Municipality of Morton for 20 years. He said in Winnipeg, where the disease reached epidemic proportions in 1928, the outbreak was much milder than in Boissevain.
In Boissevain, a picric acid nasal spray was used, which was then commonly thought to be an effective preventative treatment. This claim was based on flawed conclusions rather than scientific investigation. Scientists found that rhesus monkeys were particularly suspectible to contracting polio through the nasal passage, but what was found to be the case in monkeys didn’t apply to humans. Later research showed the polio virus enters a human host through ingestion via the mouth. The picric acid nasal spray’s only real effect on humans was to occasionally destroy a patient’s sense of smell and taste for a period that could last for months — it did not prevent polio.
Dr. Elliott suggested the two patients got the disease in Boissevain despite their treatment, because “it was presumed the infection had occurred before the spray was used.”
During the 1941 epidemic, daily radio talks by doctors were started by the provincial health department to explain the prevalent symptoms of polio and urge people to seek early medical intervention.
As in earlier epidemics, most of those afflicted were youngsters. By August 1, 1941, the Winnipeg Evening Tribune reported 80 per cent of the 202 cases (87 in Winnipeg) were among children under 15 with the biggest group between ages four and nine years old. “The youngest reported case was a two-months-old child and the oldest a 52-year-old man.”
The Children’s Hospital was overflowing with young patients in the convalescent stage of polio, resulting in the Children’s Home on Academy Road also being used as a therapy centre. Nurses and physiotherapists were on-hand at both facilities to assist the children in their recovery.
Unlike in past polio epidemics, Winnipeg doctors advised parents to “allow their children to mingle with playmates and in this way build up an immunity (Evening Tribune, July 29, 1941). “But they add a suggestion to keep the playing groups small and always made up of the same children, and to make children avoid undue physical strain.”
On the other hand, the doctors admitted “they do not know how to control the disease. There are many theories about prevention, none of them proven.”
Parents of children with polio convalescing at King George Hospital were only permitted to glimpse their sons and daughters from the safety of the hospital’s park-like grounds. While parents stood below on the grounds, their children shouted at them from the “top-floor ward of the red-brick building, or from one of the lower floors.”
According to an August 5, 1941, report in the Evening Tribune, “The three weeks’ isolation makes parents fret because they cannot see their children — at least for two weeks before the window-talking stage — because they cannot talk to them on the telephone, and cannot get letters from them.”
The parents were permitted to send letters, but it was a one-way communication. To find out how their children were faring, parents depended upon doctors and friendly switchboard operators.
“They are told twice a day, if they are fortunate parents; ‘Your child’s condition is good. He had a good night. No complaints.’”
The newspaper said as the “good nights” piled up, the anxiety of parents decreased.
As part of an effort to relieve the anxiety of parents, a Tribune reporter was given a “well-guarded” tour of the polio wards.
“In those wards, today (August 5), there are 67 city and 33 country cases of definite infantile paralysis,” wrote the reporter. “But with many of them the disease is of the mild form, and the majority have no trace of paralysis. All of them, however, will be checked over by experts in physiotherapy before the eagerly awaited trip home.”
In one ward, the reporter found a teary-eyed boy chanting: “I want to go home. I want to go home, somebody. I want to go home.”
A nearby nurse told the reporter, “He’ll be alright when he’s been here a little longer. These youngsters are excellent patients.”
By the end of the 1941 epidemic, 20 people had died in Manitoba from polio complications.
A year prior to the outbreak of Manitoba’s most serve polio epidemic in 1953, the death toll was 30 out of 841 polio cases.
In March 1953, F.C. Bell, Manitoba’s health and welfare minister, announced the 1952 epidemic resulted in 72 cases requiring treatment using iron lungs with 19 requiring extended treatment. During the epidemic the province had purchased eight iron lungs, while three were still on order in early 1953. “In addition, the government paid transportation costs for all iron lungs loaned by other provinces and by the army,” according to the March 3, 1953, Winnipeg Free Press.
The iron lung was described as both an instrument of “hope” and a “prison” by those patients encapsulated in the machines. Known as the Drinker Respirator, after its creator Dr. Philip Drinker, the iron lung was first successfully used in 1928 at Children’s Hospital in Boston to assist polio patients to breathe.
Bell said 420 patients had fully recovered after the 1952 epidemic in Manitoba, about 130 had slight paralysis and 110 had mild paralysis, while another 130 had marked paralysis and were left severely handicapped.
Bell announced funding of $70,000 to King George Hospital and $25,000 to the Children’s Hospital to pay for the costs of polio treatment in 1952.
By 1953, the provincial government covered the costs of all polio patients for the first 21 days of their hospitalization with payments starting after the expiration of any insurance coverage such as Blue Cross. Patients were liable for the normal ward costs plus ordinary costs from the 21st to the 90th day in hospital. After the 90th day, the government covered all costs. The average length of stay for a polio patient in King George Hospital was 34 days.
Bell said the government would pay all patients’ “extraordinary” (drugs and nursing) costs incurred during the entire epidemic. The only exception was that hospitals were required to pay for iron lung costs for February and March.
That a new polio epidemic was striking Manitoba in 1953 became evident by mid-July, although the number of cases had been steadily increasing since the first reported polio infections in the week of June 6 to 13. It would emerge that the 1953 epidemic in Manitoba was the most severe outbreak in Canada’s history, as well as being the nation’s last.
Dr. Roger Cadham, Winnipeg’s acting medical health officer, said nurses were urgently needed at King George Hospital because “a lot of polio cases have been admitted there” (Free Press, July 20, 1953). It was reported the polio toll had climbed to 198 reported cases with 95 cases in Winnipeg. Of these cases, five people died and 134 cases showed paralysis.
Dr. M.R. Elliott, Manitoba’s deputy-minister of health and welfare, said the extent of the epidemic and the increasing number of patients resulted in a serious shortage of nurses.
The Committee on Polio, created to oversee measures to fight the epidemic, appealed for 16 registered and practical nurses to serve in King George Hospital’s polio wards.
“Our nurses have been working two to three hours overtime almost every day and most have (only) taken one day off a week,” Elliott told the Free Press nearly two months later as the epidemic and the nursing crisis intensified.
*Peter Thompson is the uncle of the article’s author.
(Next week: part 2)